An alternative to a single shared emergency telephone number
In the capacity of operation centres for the health services, the medical emergency divisions need to be able to quickly establish efficient communication with the police, who are charged with the general-level management of crises and disasters. We believe that the exercise showed that this can be solved with the aid of modern video conferencing systems without replacing the current well-functioning national public emergency medical number 113 with one shared public emergency number (type 911 or 112) for police, fire and medical emergencies as proposed by the Norwegian Government (3). The management room at Tromsø police headquarters could easily be linked to VEMI, and during this exercise we succeeded for the first time in Norway in establishing an inter-disciplinary, ‘virtual crisis management room’ where different emergency response services could be in charge from existing emergency response centres even from remote locations.
The proposal to replace the current national system in Norway (three public numbers, separate dispatch centres for fire, police and medical emergencies) with «one shared public emergency telephone number» and «shared emergency response centres» launched by the Government has met with strong resistance (4) – (7). If the government nevertheless pushes through its proposal, the medical emergency number 113 and the current emergency medical dispatch centres will disappear, and 112 will remain the only public emergency telephone number. New, joint operation centres must be built. They are unlikely to be located at hospitals as they currently are, and the emergency medical dispatch centres will close the close contact with the medical expertise in the hospitals. Only few actions require close operational coordination between the three emergency response services, and these are easily solved by means of a rapidly established conference link between fire, police and medical dispatch centres.
It has not been demonstrated that a change from three to one shared public emergency telephone number will improve the response to medical emergencies. On the contrary; when the police, fire and medical emergency public numbers and dispatch centre were merged to one number and joint centres in Finland, waiting time, total response time as well as misuse of ambulances all increased (8). The use of ambulances increased when compared to the reference period prior to the reform. The number of erroneous assessments of clinical priorities also increased (8, 9).
The current pilot project initiated by the Ministry of Justice and Public Security involving «a single public emergency telephone number» and «a single emergency response centre» in Vestre Viken Health Trust is likewise quite controversial (10, 11). The project is based on an outdated concept, outdated technology and an inappropriate co-location of the emergency response services. No report published after the 22 July tragedy has indicated that a shared public emergency telephone number (112) or joint emergency response centres will be a solution to challenges in terms of disaster preparedness in Norway (12) – (14). Our assertion is that development of new methods for virtual co-location of management, tailored to each crisis situation, is a far better solution than a poorly planned and weakly based trial project. The national oil-company Statoil has already copied and established a system similar to VEMI for communication between 24 offshore installations, emergency medical dispatch centres in Bergen and Trondheim (15, 16).
A «virtual emergency medical dispatch centre» on the basis of the VEMI platform ought to be further developed into a modern tool for crisis management – as an alternative to a single public emergency telephone number and joint emergency response centres.